![]() In 1991, Serb paramilitary forces massacred more than 250 men at a farm outside the Croatian city of Vukovar after they had been removed from the city’s hospital. But that case did not involve a physical attack on a hospital. The only international prosecution for a hospital-related offense grew out of an incident during the war in the former Yugoslavia more than a quarter-century ago. One reason the attacks continue is because, no matter how repulsive they are, the perpetrators have always escaped accountability. In the period between 20, health facilities were attacked in war zones on average every other day. ![]() But from the Franco-Prussian War in the 19th century through two world wars, Korea, Vietnam, and post-Cold War conflicts, the attacks have been a common feature of war and political conflict. The prohibition preceded by almost a century the global compacts outlawing punishment for one’s ideas, arbitrary imprisonment, or torture. For more than 150 years, international law has barred combatants from inflicting violence on hospitals. The violence is not only morally abhorrent it is also a war crime, whether the attack targeted health facilities or was part of assaults on civilians generally. People gather around the rubble of a hospital supported by Doctors Without Borders near Maaret al-Numan, in Syria’s northern province of Idlib, in 2016, after the building was hit by suspected Russian air strikes. In these wars, the attacks were part of a broader campaign not only to defeat an adversary but to punish or forcibly displace civilians for supporting Russia’s enemy. When Syrians began moving hospitals underground and in caves, Russia used 1,000-pound “ bunker buster” bombs against them. In Syria, it joined the Assad regime in bombing and launching missile attacks against hospitals located in opposition-controlled areas between the two perpetrators, more than 500 hospitals were hit. In the war in Chechnya from 1999 to 2000, for instance, Russia destroyed or severely damaged hospitals in the capital, Grozny, and elsewhere while targeting doctors who provided care to all in need. In recent decades, Russia has been among the worst perpetrators of attacks on health care in conflicts. Given Russia’s record, no one should be surprised by these atrocities. Patients have been moved into dank basements that are usually considered inappropriate for care, just as a precaution. Volunteers have been shoveling sand into bags and bringing them into hospitals to protect them, as much as possible, from the impact of heavy weaponry. ![]() Doctors, emergency responders in ambulances, and patients have all been killed. The World Health Organization has already found sufficient evidence to confirm 24 of them on its dashboard of global attacks on health care. Even childbirth was not exempt from Russia’s strategy in the war.Īttacks on hospitals and ambulances began on the first day of the war and have continued at a rate of about one or two per day, now totaling more than 60, according to the Ukrainian Ministry of Health. The high number of injuries, the sheer size of the craters caused by the explosion, the reports that it was heard a mile away, and the contemporaneous visual evidence easily refute Russia’s denials of waging war on civilians. The photo of a pregnant woman, possibly in labor, being carried out of a destroyed maternity and children’s hospital struck by Russian forces in the city of Mariupol became yet another iconic image of Russia’s assault on civilians in its war against Ukraine. He is the author of Perilous Medicine: The Struggle to Protect Health Care from the Violence of War. Leonard Rubenstein is a professor of practice at the Johns Hopkins Bloomberg School of Public Health and core faculty at the Johns Hopkins Berman Institute of Bioethics. ![]() Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.
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